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Organization

UPSTART CHILDREN'S THERAPY CTR, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. DONNA GIBSON (PRESIDENT)
(708) 955-2213
Entity
Organization

Contact information

Practice address
18909 LORENZ AVE, LANSING, IL 60438-3434
(708) 955-2213
Mailing address
18909 LORENZ AVE, LANSING, IL 60438-3434

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary

Other

Enumeration date
07/14/2022
Last updated
07/14/2022
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